Motto of the day

Poisons and medicine are oftentimes the same substance given with different intents

Peter Mere Latham

obrazek winietyobrazek winiety

Scientific publications

Gemcitabine and cisplatin combined with regional hyperthermia as second-line treatment in patients with gemcitabine-refractory advanced pancreatic cancer

Publishing house: International Journal of Hyperthermia
Main author: Katharina Elisabeth Tschoep-Lechner
Other authors: Valeria Milani, Fank Berger, Nelli Dieterle, Sultan Abdel-Rahman, Christoph Salat, Rolf-Dieter Issels
Date: 2012-10-13

DOI: 10.3109/02656736.2012.740764

Language: english

Publication class: Retrospective study

Research type: Non randomized, single center

Number of patients: 23

HT type: LRHT RF

Description of HT type: Local HT, deep, radio waves

Device: BSD-2000

Disease entity: Advanced pancreas cancer

Symbol of disease entity: APC

Stage:  -

Types of combination with HT: HT + CT

CT type: Gemcitabine, Cisplatin 

Abstract. Purpose: There is no standard second-line therapy for patients with advanced pancreatic cancer (APC) after gemcitabine (G) failure. Cisplatin (Cis)-based chemotherapy has shown activity in APC. It is proven that  cytotoxicity of G and Cis is enhanced by heat exposure at 40  to 42 C. Therefore G plus Cis with regional hyperthermia (RHT) might be beneficial for patients with G-refractory APC.
Patients and methods: We retrospectively analysed 23 patients with advanced (n¼2) or metastatic (n¼21) pancreatic cancer with relapse after G mono first-line chemotherapy (n¼23). Patients had received G (day 1, 1000 mg/m2) and Cis (day 2 and 4, 25 mg/m2) in combination with RHT (day 2 and 4, 1 h) biweekly for 4 months. We analysed feasibility, toxicity, time to second progression (TTP2), overall survival (OS) and clinical response.
Results: Between October 1999 and August 2008 23 patients were treated. Haematological toxicity was low with no grade 4 event. Hyperthermia-associated toxicity consisted of discomfort because of bolus pressure (3%), power-related pain (7%) or position-related pain (17%). Median TTP1 was 5.9 months (95% confidence interval (CI): 2.6–9.2), median TTP2 was 4.3 months (95%CI: 1.2–7.4) and OS 12.9 months (95%CI: 9.9–15.9). The disease control rate in 16 patients with available CT scans was 50%. 
Conclusions: We show first clinical data of G plus Cis with RHT being clinically active in G-pretreated APC with low toxicity. A prospective controlled phase II second-line clinical trial (EudraCT: 2005-003855-11) and a randomised phase III adjuvant clinical trial offering this treatment (HEAT; EudraCT: 2008-004802-14) are currently open for recruitment.

Need more information about the article? Please contact with PTHO by email.